Adults in OECD countries, consume, on average, the equivalent of about 9 litres of pure alcohol per capita per year, and more than 10 litres if one takes into account the unrecorded consumption. Alcohol consumption, in moderation, brings many people pleasure, and is a source of jobs. But harmful consumption bears a heavy cost on individuals and on society. When people consume too much alcohol, too quickly, they seriously damage their health and put other people’s lives at risk, imposing huge costs on our economies. This is what our new report aims to address: how to tackle heavy and binge drinking.

Harmful drinking is on the rise

Let me start with some key facts on alcohol consumption.

Many OECD countries rank among the heaviest drinking countries worldwide. Alcohol consumption has been declining slightly, overall, and we have seen some dramatic falls, for instance, in southern European countries. France has decreased its consumption by one quarter in the past 20 years, Italy has moved from being one of the heaviest-drinking countries to the opposite end of the table in the same period.

But in some other countries, alcohol consumption has been on the rise. People living in Poland, Israel and Norway, for example, have increased their consumption of alcohol by more than 25% during the last 20 years.

Very alarming is the rise in heavy drinking, particularly binge drinking in young people and women in many countries, including in those countries where alcohol consumption is dropping. Let me stress three sorts of harmful consumption:

• In some countries, 20% of the population consume two-thirds of all alcohol. Many of these people become dependent on alcohol, with terrible consequences.

• By the age of 15, 40% of children have been drunk at least once, on average, across the OECD. This is long before their bodies are capable of coping with alcohol, and contributes to an increased likelihood of addiction in the future.

• Lastly, the trends regarding gender and drinking are not comforting. Young girls are now as likely as young boys to drink and get drunk. In general, there has been a substantial increase in the number of women reporting regular binge drinking.

Harmful drinking is very costly to societies

Harmful drinking takes a devastating toll on society. Alcohol is linked with more than 200 diseases including cancers, injuries and neurological problems. Harmful alcohol use is the fifth leading cause of death and disability worldwide, up from 8th in 1990. Every 10 seconds somebody dies from a problem related to alcohol and many more develop an alcohol-related disease.

Heavy drinking also harms people other than drinkers themselves through traffic injuries and fatalities, violence and anti-social behaviour, as well as increased foetal development disorders when alcohol is absorbed during pregnancy.

Finally, alcohol imposes an economic burden on countries both through direct healthcare expenditure and through productivity losses. In Europe, for example, the cost of crime related to alcohol is 33 billion dollars per year, and the cost associated with alcohol-related traffic accidents is 10 billion dollars. In most countries, productivity losses have been estimated in the region of 1% of GDP.

Reducing harmful alcohol use is within reach

In 2013, the World Health Assembly adopted a voluntary target of reducing harmful alcohol use by 10% by 2025, as part of the Global Monitoring Framework on non-communicable diseases. The good news from the OECD’s work is that this target is achievable.

We have carefully reviewed hundreds of evaluations of different approaches to cutting harmful alcohol consumption across the world. We have identified the consensus around diverse policy approaches, and created a detailed simulation model of their impact.

Our results point to a clear conclusion: a comprehensive prevention strategy, combining regulation with medical intervention and price strategies, could reduce harmful consumption of alcohol towards the 10% reduction target. In particular, counselling by physicians in primary health care, a tighter enforcement of regulations to prevent drinking-and-driving and alcohol-related violence, price policies and regulation of the promotion of alcohol together provide an effective, affordable and cost-effective solution.

These policies have the potential to prevent alcohol-related disabilities and injuries, with major potential gains in health, longevity and productivity. In Germany alone, for example, we can expect that every year about 150,000 injuries and about 110,000 cases of mental health conditions could be averted. This could be achieved with an investment of about 5 dollars per person per year, but most of these alcohol policies pay for themselves through the savings they can generate in health care expenditures. Even the most expensive interventions would still be highly cost-effective.

Overall, it is possible to cut harmful consumption of alcohol by 10%, but another important conclusion of our work is that to achieve this result, policies need to address more general alcohol related habits.

Policies targeting problem drinkers are a must. We should be enforcing our drink-driving laws more effectively, and in some countries, considering tightening them. We should also be making family doctors much more aware of the problems of harmful drinking, ensuring that they identify problem drinkers and that they then help people address their excessive consumption. Today less than 10% of those that would benefit from medical and psychological treatment for alcohol problems receive it.

But, on their own, our analysis shows that these policies are unlikely to cut problem drinking by more than 5%. To go further will require higher taxes, minimum prices for alcohol, or restrictions of sales. Such measures will also affect moderate drinkers. This gives governments a dilemma – how do they balance the rights of the relatively safe drinker with the costs imposed by heavy and hazardous drinkers? This is not a question that economics can answer; each country will have to weigh the evidence in their own circumstances.

Tackling harmful consumption of alcohol is not the responsibility of governments alone. Business stakeholders have stepped up their corporate social responsibility efforts. In the United Kingdom, for instance, businesses have committed to removing one billion units of alcohol per year from the market by December 2015. These actions can contribute to tackling harmful drinking, but we need more independent evidence that they really work.

Ladies and gentlemen,

This has been a complex report to produce. The OECD Health Committee decided to work on this in 2011. Since then there have 3 major meetings of technical experts, and 3 discussions by senior health officials from all OECD countries at the Health Committee, before the Committee decided unanimously to publish this report under my responsibility – as is the case with all OECD reports on health and in many other fields -- in December 2013. The report was further improved in 2014 and shared with countries for their final comments in December 2014. In addition, we have organised many meetings with stakeholders, including also the alcohol industry, to discuss the analysis and its main findings. This intensive scrutiny has hugely improved the quality of the report, and I would like to pay tribute to all those in national capitals who have devoted so much of their time to reviewing our work.

Five years ago I launched our report on obesity – Fit not Fat. I recall the surprise among many people that an organisation with the word ‘economic’ in its title was addressing an issue such as obesity. But today no-one doubts that obesity poses a threat to our health systems, our labour markets and our economies.

The same is true of harmful alcohol consumption. Binge drinking and heavy drinking carry devastating personal and social consequences, they increase health spending and reduce our standard of living. Through efforts such as this report, the OECD will continue to help countries identify the most promising ways of tackling this problem and promote better policies for better, healthier lives.